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Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
Published on: August 17, 2017
Nutritional and Biochemical Markers Associated with Early Outcomes in Elderly Patients with Femoral Neck Fracture: A
Devinder Kumar1, Neelam Kumari2, Vipan Kumar1
1Department of Orthopaedics, DR RPGMCKangra, Tanda, Himachal Pradesh India.
Purpose:
Elderly patients with femoral neck fractures remain at high risk for postoperative complications and mortality. While age and comorbidities are well-established determinants, the prognostic relevance of routinely available nutritional and biochemical parameters requires further investigation. This study evaluated the association between nutritional and biochemical markers at admission and early postoperative outcomes in older adults who underwent surgery for femoral neck fracture.
Methods:
A prospective observational study was conducted on 90 patients aged ≥ 60 years who underwent bipolar hemiarthroplasty or total hip replacement for displaced femoral neck fracture. Baseline demographic, nutritional (body mass index, mid-arm circumference, and serum albumin), and biochemical variables (hemoglobin, lymphocyte count, urea, creatinine, sodium, and potassium levels) were recorded at admission. Patients were followed up at 15, 45, and 90 days and at 1 year to assess mortality and wound status. Associations were analyzed using appropriate statistical tests, with an emphasis on effect estimates.
Results:
Five patients (5.6%) died within 90 days and eleven (12.2%) died within 1 year. Elevated serum urea (p = 0.033), higher creatinine (p = 0.031), and lower sodium levels (p = 0.049) at admission were significantly associated with higher mortality. Survivors had higher mean BMI and serum albumin levels, although these differences were not statistically significant. Wound complications at 15 days were strongly associated with mortality (p = 0.007).
Conclusion:
Simple and routinely available nutritional and biochemical markers, particularly serum urea, creatinine, and sodium levels, were significantly associated with early mortality in elderly patients with femoral neck fractures. Incorporating these parameters into routine preoperative assessment may assist in risk stratification and perioperative optimization, especially in resource-limited settings. Larger studies with multivariate analyses are warranted to refine their prognostic utility.